Prognostic Value of CAR, AFR and Ferritin in Non-M3 AML

September 3, 2026 updated by: Aya Salah Noureldin, Assiut University

The Prognostic Significance of C-Reactive Protein to Albumin Ratio, Albumin to Fibrinogen Ratio, and Serum Ferritin Level in Newly Diagnosed De Novo Non-M3 Acute Myeloid Leukemia Patients

This prospective cohort study aims to evaluate the prognostic significance of the C-reactive protein-to-albumin ratio (CAR), albumin-to-fibrinogen ratio (AFR), and serum ferritin level in newly diagnosed de novo non-M3 acute myeloid leukemia patients at Assiut University Hospitals.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Acute myeloid leukemia (AML) is an aggressive hematological malignancy with poor clinical outcomes. Inflammatory and nutritional biomarkers such as the C-reactive protein-to-albumin ratio (CAR), albumin-to-fibrinogen ratio (AFR), and serum ferritin have shown potential prognostic value in various malignancies.

This prospective single-center cohort study will include newly diagnosed de novo non-M3 AML patients aged 18 to 65 years. Baseline laboratory parameters including CRP, albumin, fibrinogen, and ferritin will be measured before induction chemotherapy. Patients will be followed for overall survival, event-free survival, and response to induction therapy. The study will assess the association of CAR, AFR, and serum ferritin with clinical outcomes.

Study Type

Observational

Enrollment (Estimated)

208

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Newly diagnosed de novo non-M3 acute myeloid leukemia patients admitted to the Internal Medicine Department at Assiut University Hospitals.

Description

Inclusion Criteria:

  • Age 18 to 65 years

    • Newly diagnosed de novo non-M3 acute myeloid leukemia
    • Both sexes
    • Willingness to provide informed consent

Exclusion Criteria:

  • - Patient refusal
  • Significant cardiac, hepatic, or renal disease
  • Diabetes mellitus with polyneuropathy
  • Severe organ dysfunction (modified Marshall score ≥ 2)
  • History of MDS transformed to AML
  • Previous blood transfusions
  • Relapsed AML
  • Previous exposure to chemotherapy or radiotherapy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Single cohort: Newly diagnosed de novo non-M3 AML patients
Adult patients aged 18-65 years with newly diagnosed de novo non-M3 acute myeloid leukemia who will receive induction chemotherapy according to institutional protocols.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall survival
Time Frame: Up to 24 months
Time from the date of AML diagnosis to death from any cause or last follow-up for surviving patients.
Up to 24 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Complete remission rate after induction chemotherapy
Time Frame: Day 28 after induction chemotherapy
Proportion of patients achieving complete remission after induction chemotherapy, defined as bone marrow blasts less than 5%, absolute neutrophil count greater than 1.0 × 10⁹/L, platelet count greater than 100 × 10⁹/L, and independence from red cell transfusions.
Day 28 after induction chemotherapy
Event-free survival
Time Frame: Up to 24 months
Time from diagnosis to the first occurrence of treatment failure, relapse, or death from any cause.
Up to 24 months
Prognostic value of C-reactive protein-to-albumin ratio (CAR)
Time Frame: Baseline and up to 24 months
Hazard ratio for overall survival and event-free survival according to baseline C-reactive protein-to-albumin ratio (CAR), calculated as CRP (mg/L) divided by serum albumin (g/L), using Cox proportional hazards regression.
Baseline and up to 24 months
Prognostic value of albumin-to-fibrinogen ratio (AFR)
Time Frame: Baseline and up to 24 months
Hazard ratio for overall survival and event-free survival according to baseline albumin-to-fibrinogen ratio (AFR), calculated as plasma fibrinogen concentration (g/L) divided by serum albumin concentration (g/L), using Cox proportional hazards regression.
Baseline and up to 24 months
Prognostic value of serum ferritin
Time Frame: Baseline and up to 24 months
Hazard ratio for overall survival and event-free survival according to baseline serum ferritin level (ng/mL, corrected if CRP is elevated), using Cox proportional hazards regression.
Baseline and up to 24 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Investigators

  • Study Chair: Mohamed R Hameed, prof, Internal medicine, clinical Hematology & bone marrow tramsplant unit

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

September 1, 2027

Study Completion (Estimated)

September 1, 2028

Study Registration Dates

First Submitted

September 1, 2026

First Submitted That Met QC Criteria

September 3, 2026

First Posted (Actual)

September 9, 2026

Study Record Updates

Last Update Posted (Actual)

September 9, 2026

Last Update Submitted That Met QC Criteria

September 3, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • AML-CAR-AFR-Ferritin-Assiut-20

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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